Adult Learning Theories for Clinical Teaching Nurses


Distinctive adult learning theories take in the fundamental concepts of behavioral transformation and skill. From there, complexity instigates to deviate precise theories and concepts in diverse borage of inferences (Vandeveer & Norton, 2005). Up until the 1950’s, indispensable definitions of learning were built about the scheme of change in behavior, Subsequent to this summit more complexities have been introduced.

For example, whether individual is required to perform in order for learning to have taken place or whether all people behavior is scholarly (Waddill, 2004). Hinchliffe, S. (2004), defines learning as a “comparatively permanent transformation in behavior with behavior including both visible doings and inside processes, for example judgment, attitudes and emotions”. Therefore, Burns includes inspiration in this explanation of learning.

Hinchliffe, S. (2004), further considers that learning capacity might not evident itself in visible behavior until some time after the learning program has taken place (Marquardt and Waddill, 2004).There is numerous different theories of how people gain knowledge. Most of these theories are applied depending with the concepts being communicated by the tutor, the level of understanding of the students and the expectation of the students in their field of application. All these comprehended by testing the students after every course work taught. It is exciting to think about your own particular technique of teaching and to distinguish that each one does not learn the way you do (Sawchuk, 2008).

According to Stith, et al, (1998), the observation among instructors, is an important area of study if teaching is to uphold its high standing. So it was imperative for the development of this theories and models of education. For example, the teachers who are the most knowledgeable in specific field can teach and deliver direct source of information. For the reason that teachers work within the entire environment of the delivery system and can recognize the weakness of each party. Therefore, they can propose solutions to conquer such limitation and to recover the deliverance of the subject they teach.

Differences in learning styles

The idea that people learn in diverse ways has been studied over the last few decades by educational investigators. One of the most significant of these, established that individuals start with their favorite style in the experiential learning cycle and identified four learning styles: activist which enjoys the experience of itself, reflectors which they spend most of their time and efforts in reflecting, theorist which are good at making connections and abstracting ideas from experience and pragmatic which only they enjoy the planning stage.

There are strong points and weaknesses in each of these styles. Marquardt and Waddill (2004), argue that education is improved when we reflect about our learning method so that we can fabricate on strengths and work towards reducing weaknesses to advance the excellence of learning.

Action Learning

Action Learning is the approach that relate the world of education with the world of action through an insightful process based on small joint learning groups referred as ‘action learning sets’ (Marquardt and Waddill, 2004). The groups meet regularly to work on individual members; they deal with issues touching real-life with the objective of learning together as well as learning from each other.

The founder of Action Learning, Reg Revans, said that learning can not take place without action and no deliberate or sober action without learning. Revans believed that education can be shown by the following equation; L = P + Q where L is learning; P is programmed knowledge (instruction given at any time) and Q is questioning. Revans and others investigated and taught about this approach, proved that Action Learning is significantly ideal for finding solution to problems that do not have specific answer because the required questioning imminent can be made easy by individuals learning with and from each other in action learning.

Types of learning theories

Adult Learning (Andragogy)

According to Vandeveer& Norton (2005), “Andragogy, differ with pedagogy, it means the art and science of assisting adults learn” Knowles marked andragogy as an up-and-coming expertise which facilitates the growth and execution of learning behavior for adults. This up-and-coming expertise is based on five andragogical assumptions;

  1. Self-directness: As an individual grows to maturity, he or she learns to be independent
  2. Skill: Adults depict upon their know-how to support their learning.
  3. Keenness: The learning inclination of a mature person is directly correlated to the postulation of fresh collective roles.
  4. Point of reference: As an individual learns new knowledge, he or she desires to apply it right away in problem solving.
  5. Stimulus: As an individual matures, he or she receives their inspiration to learn from internal influences.

In critical analysis of these assumptions, there is merging with the view and theories of others. Vandeveer & Norton (2005), point out three important keys to transformational learning: skill, decisive reflection and development. The aspect of skill seems like a significant reflection in creating an efficient learning opportunity for nurses. The learning occasion requires being applicable and relevant to an individual’s set of experiences.

Within this context, nurses learning are aimed at not only improving individual knowledge and skill, but eventually it is the objective to advance the nurses performance by transfer of learning straight to work applications (Prinsen, et al, 2007). Yi put forward three methods to encourage learning in adult organizations which can also be of great benefit to nurse teaching institution: Problem-Based learning which seeks to boost problem-solving and decisive judgment skills; Mutual Learning, which builds communication and interpersonal skills; and Positioned Learning, which targets precise procedural skills that can be straight linked to the field of occupation. (Levett-Jones, 2005)

Experiential learning

Experiential Learning Theory emphasizes the fact that a proper experience plays an important role in the learning process. It is this importance that differentiates itself from other learning theories. Intellectuals in the field of education have two complementary ideas when it comes to the theory of experiential learning. The first observation defines experiential learning as a kind of education which allows students to relate newly acquired information in a relevant setting. The relevant setting can be a sponsored institution of learning with instructors, tutors, lecturers or professors to guide the lesson.

The other school of thought describes experiential learning as teaching that occurs as a straight involvement in the events of life. Thus, learning is not realized in a formal setting, but in applies of the reflection of day by day experiences. They advanced the subsequent description of experiential learning by developing a model which details learning method through practices.

Experiential learning model is a progression spiral process which forms four fundamental elements: Concrete experience, Observation and reflection, forming abstract concepts and testing in new situations. Following these concepts, the student is required to have some experience in the process of learning. This can be achieved through observation and reflection of the ideas taught in class, internalizing the ideas and putting the ideas taught theoretically into practical in their field of work.

However, Fresh graduates nurses are inexpert, and since they require the proficiency and skills necessary to stand up for themselves, they are frequently yelled at, ridiculed and dehumanized It is important for veteran staff to embrace the new graduates and shore up and support them as a group (Ashton, 2004). Unfortunately, new graduates accept this behavior as a rite of passage and move on, only to mimic it later on, as it is what they have learned from their predecessors. Nurses require being aware of who it is they are touching and begin to build up new behaviors that will benefit each other’s self-esteem (Adams, 2000).

Conditions/Environment surrounding learning

Some studies advocate that situational conditions making up an environment can encourage or discourage learning. These conditions perhaps are created by managerial structure, constructive or depressing environmental conditions, or time restraint. Richardson (2005), suggest, “The learning potentials of managerial members are, at any rate in part, collectively constructed by nationalized, professional, or other organizations”.

He further advocated those internal peripheries are established by area of expertise or responsibility within the structure of organizations that obstruct cross-boundary learning (Levett-Jones, 2005). Constructive results are much more pertinent to end result in an encouraging and successful learning experience. This theory follows the transformational leadership theory providing encouraging chances for individuals to develop within the outline of organizational life.

For instance, the main basis why nurses exit their job is the view of a lack of professional respect and appreciation by hospital administrators, doctors and the broader community. Nurses are supposed to work within hospital hierarchies, in such a hierarchical environment, doctors are perceived as the only probable professional voice in health and nurses are simply ‘handmaidens’, despite the fact that they are well trained employees(Richardson, 2005).

Anxiety and the nurse Learner

The organizations hardly ever change the behaviors within the organization. Some intellectuals dismiss the belief that learning is fun, especially for nurses; Organizations be obliged to find a way to deal with the anxiety nurses experience when they are forced to learn what they know and learn something new. Ashton, D. (2004) talks about two sorts of anxiety: learning and survival anxiety. It is in this approach that he concluded that “learning will only happen when survival anxiety is greater than learning anxiety”.

However, these anxieties may perhaps be dealt with, for instance nurses learning can be created in a safe environment where the outcome of failure are negligible. Survival anxiety can apparently be increased by intimidating job loss, lack of safety measures, or distinguishing aggressive elements of the work place (Ashton, D. 2004).

Conclusions and Recommendations

Theoretically, a nurse in a busy surgical ward feels immobilized; hence they tend to become aggravated, and are incapable to effectively express their distress about the system. If verbal expression is frustrated up the chain, workers may use their voice and deeds to express their irritation toward one another.

This damaging relation may lead to tension and disagreement in work place, eventually creating victims of circumstances between doctors and nurses. Both perpetrator and victims may build up a lack of trust in their partner associated to their incapability to positively revolutionize the system. This may result in low confidence in individuals and low group morale; generate a cycle that, if permitted to persist, may add extensively to troubles with preservation (Griffin, 2004).

Nurses, can apply the processes needed to get the correct treatment of a patient, but he/she doesn’t understand the medical concepts behind the process. This means nurses have a hard time when they need to use problem solving skills and establish which tool to use in a medical problem. For instance, they have learned to use specific tools when there are linkage casualties. The theories aimed at collecting information and merging them to improve teaching delivery (Clark, C., 2008). Most of these theories touches all elements of the educational system: the curriculum, the teacher, the students, the supervisor and the school system.

In Summary, proposed actions for nurse teachers to improve its delivery could be translated in the following recommendations:

  • Nurses training institution should appoint specialized personnel tutors and supervisors and to adequately train them to perform their jobs with an acceptable level.
  • Teaching staff should make the syllabus modern, pertinent to students’ needs and ability, in requirements of altitude of complexity and size of the matter content.
  • Management of the institutions should improve the administration perceptions and implied practices relating to nurses.
  • Management, teaching staff and supervisors should pay attention to students’ and parents attitudes towards nurses’ courses and to provide them with informed knowledge about the career.
  • Institution to undertake some remedial actions in the institution system that enable for refreshment course. Among these actions should allow for field visits by teaching team.


Adams, A., Lugsden, E., Chase, J., Arber, S., & Bond, S. (2000). Skill mix changes and work intensification in nursing. Work, Employment & Society 14(3), 541-555.

Ashton, D. (2004). The impact of organizational structure on learning in the workplace. International, Journal of Training & Development, 8(1), 43-53.

Clark, C. (2008). Classroom skills for nurse educators. Sudbury: Jones and Bartlett Publishers.

Hinchliffe, S. (2004). The practitioner as teacher (3rd ed.). London: Churchill Livingstone.

Levett-Jones, T. (2005). self directed learning: Implications and limitations for undergraduate nursing education. Nurse Education Today. 25 363-368.

Marquardt, M., and Waddill, D. (2004). The power of learning in action learning: a conceptual analysis of how the five schools of adult learning theories are incorporated within the practice of action learning. Action Learning: Research and Practice, 1(2) 185-202.

Prinsen, F., Volman, M., & Terwel, J. (2007). The influence of learner characteristics on degree and type of participation in a CSCL environment. British Journal of Educational Technology, 38(6), 1037-1055.

Richardson, V. (2005). The diverse learning needs of students. In D. Billings & J. Halstead (Eds.), Teaching in nursing: a guide for faculty (2nd ed.). St Louis: Elsevier Saunders.

Sawchuk, P. (2008). Theories and methods for research on informal learning and work: towards cross-fertilization. Studies in Continuing Education. 30(1) 1-16.

Stith, J., Butterfield, W., Strube, M., Deusinger, S., & Gillespie, D. (1998) Personal, interpersonal, and organisational influences on student satisfaction with clinical education. Physical Therapy, 78(6), 635-645.

Vandeveer, M., & Norton, B. (2005): From teaching to learning: Theoretical foundations. In D. Billings & J. Halstead (Eds.), Teaching in nursing: a guide for faculty (2nd ed.). St Louis: Elsevier Saunders.

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